我国突发公共卫生事件应急处置政策变迁：2003—2013年

2003年SARS疫情以后,突发公共卫生事件应急处置工作得到高度重视,相关政策文件也在逐步完善。本文系统检索了我国十年来颁布的近百项国家层面的突发公共卫生事件应急处置政策,并从应急预案制订、应急队伍组建与培训、应急物资保障、信息报告要求、现场处置分工、应急评估工作和治理方式七个方面进行政策变迁分析。研究发现：十年来,突发公共卫生事件应急处置政策逐步细化,详细规定了应急预案的内容;明确了应急队伍构成和队伍培训工作内容;加强了应急物资保障制度的建设;明晰了应急现场处置各方职责;逐步重视应急处置的评估工作。但突发公共卫生事件应急处置仍以被动治理为主,且相关政策缺乏操作性,物资配备标准适用性差,时效性差。需及时转变理念,完善更新突发公共卫生应急处置政策及相关规范、标准。     

推行妇幼保健保偿制的实践与体会

日照市加强领导,精心部署,为妇幼保健保偿制的推行提供强有力的组织保障;广泛宣传,搞好协调,为妇幼保健保偿制的推行营造良好的社会氛围;强化内涵建设,完善服务功能,努力构筑推行妇幼保健保偿制的支撑体系;健全队伍,增强素质,为入保者提供优质高效的妇幼卫生服务。从而,赢得了人民群众的信赖,妇幼保健保偿覆盖面不断扩大,孕产妇系统化管理率稳步提高,孕产妇、婴幼儿死亡率大幅度降低。     

城镇居民基本医疗保险与新型农村合作医疗制度相衔接的医疗费用控制探析报告：江苏省常熟市追踪报告之二

常熟市在开展两制衔接以来,采取了多元化控制医疗费用的管理方式,有效地控制了医疗费用。文章对其费用水平进行了分析,并对控费方式进行了探讨。     

Sexual abuse as a factor in adolescent pregnancy and child maltreatment.

Two-thirds of a sample of 535 young women from the state of Washington who became pregnant as adolescents had been sexually abused: Fifty-five percent had been molested, 42 percent had been victims of attempted rape and 44 percent had been raped. Compared with adolescent women who became pregnant but had not been abused, sexually victimized teenagers began intercourse a year earlier, were more likely to have used drugs and alcohol and were less likely to practice contraception. The abused adolescents were also more likely to have been hit, slapped or beaten by a partner and to have exchanged sex for money, drugs or a place to stay. Young women in the abused group were also more likely to report that their own children had been abused or had been taken from them by Child Protective Services.     

Evaluation of a strategy of screening multiple anatomical sites for methicillin-resistant Staphylococcus aureus at admission to a teaching hospital.

We compared the sensitivity of screening with nasal culture alone with that of a multiple-site screening method for the identification of carriers of methicillin-resistant Staphylococcus aureus at hospital admission. If nasal cultures alone had been used during the 1-year study, 27.0% of carriers of methicillin-resistant S. aureus would have been missed, which corresponds to 560 theoretical isolation days. If rectal screening had not been used, 431 theoretical isolation days would have been missed, and, if axillary screening had not been used, 99 theoretical isolation days would have been missed.     

Editorial – Advancing health promotion through professional development

Introduction: Since the 1980s, when health promotion started differentiating itself from health education and became mainstream in multidisciplinary public health, professional development issues have been an important and recurring theme. Workforce surveys have been conducted, consensus on core skills for health promotion has been sought, training programs in the process and skills of health promotion have been developed and implemented, and under‐ and post‐graduate university courses have been established.     

导入ISO9000质量管理体系提高医院质量管理水平

通过建立和完善医院质量管理体系，使得医疗服务环境不断优化，医务人员服务态度明显改善，服务行为进一步规范，医疗质量和服务水平全面提升。     

国际旅行卫生保健中心医务人员职业暴露干预模式及效果评价

目的从影响行为的3个要素出发识别国际旅行卫生保健中心（以下简称“保健中心”）医务人员职业暴露风险,建立并评价干预模式降低该人群职业暴露风险的有效性。方法采用行为流行病学干预前后对比研究的方法．通过定量与定性相结合的方式收集所需数据。结果干预模式实施后,保健中心医务人员较干预前职业暴露防护知识、自我防护意识和标准防护技能应用的主动性提高,职业暴露防护资源数量增加,有关规章制度可操作性提高,防护资源可获得性有所保障,一定程度上缓解职业紧张,职业暴露风险行为发生显著降低。结论干预模式的应用能够有效降低保健中心医务人员职业暴露风险,增加其标准防护资源的获取和标准防护利用。     

生物医用高分子材料与现代医学

随着人民生活水平的提高和现代医学的发展,生物医用高分子材料日益重要,在医疗费用中的比重也十分突出.医用高分子材料具有广泛的用途,相关材料在生物相容性等方面也有严格要求,本文对此作了概括和分类,并对其最新进展做了简单介绍.     

投资设备成本效益管理系统

针对医院投资设备的管理．依托军卫1号网络．提出成本效益管理的数据流程．建立两个主要的计算模式。在本系统中实现了对投资设备合同、收费、支出、利息计算、应付分成款以及投资设备预测、决策等的实时动态管理．减轻了人员管理的劳动强度．提高了工作效率。本系统试运行稳定、正常，数据准确、可靠。     

Pilot study on use of PMPs

Patient management problems (PMPs) have been used for many years in an attempt to design tests capable of measuring clinical problem-solving ability. Problems have arisen particularly related to criterion validity, though some studies have suggested that content and construct validity are satisfactory. One of the major problems has been that a common definition of problem-solving ability has not been developed yet. In addition, various formats have been used with considerable variety in construction, possibly influencing outcomes, and scoring procedures have not been standardized. A serious charge has been that PMPs are content specific and therefore are unreliable and not valid for measuring any general characteristic such as problem-solving ability (assuming this exists).     

Developments in Scandinavian and American medical sociology

This paper examines the similarities and differences in Scandinavian and American medical sociology. First, the issue of medicalization has not been as important in Scandinavian as it has been in American medical sociology. Second, women's health has been less explored in Scandinavian than in American medical sociology. Third, research on social inequalities and health has been a major focus in Scandinavian medical sociology since the 1990s. Fourth, cultural sociology and the poststructuralist perspective have been part of mainstream theory building in European sociology and also European and Scandinavian medical sociology during the past decade, while American medical sociology has been characterized by social-role theory and a quantitative approach.     

健康教育是农村边远贫困地区孕产妇获得产时保健的有效措施——附659例育龄妇女调查分析

为了解“降低农村边远贫困地区产后出血死亡社区干预措施”在项目县中的研究结果 ,对开展研究项目的 5个县妇幼卫生健康教育和健康促进进行调查 ,重点进行了育龄妇女的孕产期保健知识、态度、行为 (KAP)调查分析 ,评估社区干预措施的效果 ,在 5个课题县对 6 79名妇女进行了 KAP问卷调查 ,并与项目健康教育基线调查结果进行比较。结果 :育龄妇女保健知识水平较项目实施前有较大幅度的提高 ,主要是改善了对产前检查、孕期营养、新法接生、住院分娩和母乳喂养等方面的认识。从调查对象主动接受产前检查和寻求住院分娩的行为改变可观察到项目健康促进的干预效果 ,课题结束时 5县住院分娩率从 1992年的 19.6 5 %提高到 2 0 0 0年的 6 1.91%。因产后出血引起的孕产妇死亡降低一半 ,说明了广泛开展社区健康教育是农村边远贫困地区孕产妇提高利用保健服务的能力 ,获得产前保健 ,降低孕产妇死亡率的有效措施。     

呼和浩特市14岁以上支气管哮喘患者问卷调查分析

目的调查呼和浩特市14岁以上支气管哮喘患者治疗现状，了解我市对GINA方案的执行情况。方法采用调查问卷方式，对我市9所医院住院及门诊就诊的患者进行调查。结果患者对吸入型糖皮质激素的使用率为32．2％，其中坚持使用时间在1年以上的仅为2．9％，抗生素的使用率为72．3％，使用峰流速仪监测病情的仅占1．996。结论呼和浩特市14岁以上支气管哮喘患者治疗现状很差，GINA方案在我市没有真正落实。     

Nutrition and cancer The role of nutrition in the causation of cancer

A link between diet and cancer of a number of varied sites has been observed. The link is probably best documented in colorectal cancer; a plausible mechanism has been proposed and has been tested. A group of hormone-related cancers have been correlated with dietary fat. A group of tobacco-related cancers have also been related to dietary fat, presumably by a different mechanism. Some cancers have been related to alcohol consumption whilst others have been associated with malnutrition in general. This is not, therefore, a homogeneous picture but shows a varied role of diet in disease. It will have been noted that most of these dietary related cancers are diseases of affluence and are associated with ‘overnutrition’. The same diet, however, is associated with low infant mortality and appears to be protective against the more severe effect of virus infections. It may be, therefore, that we should not be hasty in modifying our diet and should first ensure that the benefits that accrue from our current diet are not lost in the change.     

传染病人负压隔离病床控制系统设计

通过实验,采用系统辨识方法获得负压隔离病床开环传递函数模型。据此模型,设计PID控制器,进行Matlab数值仿真,并优化控制参数。采用PT201型差压变送器测量负压,设计相应信号处理电路,建立以C8051F330为核心的单片机系统,实现信号采集、PID运算、键盘输入、液晶显示、风机驱动等功能。最后进行试验,验证控制效果。     

妇幼卫生专业本科教学评估体系探讨

通过近１０年的妇幼卫生本科教学探索，建立了一套比较完整的教学评估系统和方法。通过评估，改进了教学方法，提高了教学质量，收到了良好的教学效果，为妇幼卫生本科教育积累了经验。     

有效降低医院感染漏报率的路径

目的为有效降低医院感染漏报率,探索漏报监控路径,发挥医院感染监控预警系统作用,避免医院感染暴发和流行。方法以2001年卫生部颁布的《医院感染诊断标准》为诊断依据,对2000年1月-2006年12月全院116 213份出院病历进行了回顾性分析;再度评估医院感染漏报率等监控项目,寻找漏报原因、制定对策,反馈医院感染控制信息;同时在该7年期间根据医院信息系统提供的高危因素进行了前瞻性调查,以此为工作路径。结果通过本路径的实践,医院感染漏报率基本得到控制,低于三级医院的控制标准(20.0%);2005年再度强化措施,使2006年医院感染漏报率下降为7.4%。结论医院感染病例的实时监测,是有效降低医院感染漏报率的路径。     

基于服务供应链理论的缩短平均住院日管理探索

苏北人民医院将入院服务中心、检查服务中心、围手术期管理中心、加速康复团队、日间手术管理中心、医联体联合病房等医疗服务供应链上相关平台进行升级并整合,在各平台间实现信息共享、医保打通、优化绩效等协同管理措施,包括患者平均住院日等数据明显优化,医院管理水平有效提升。对医疗服务供应链上相关平台进行协同整合有助于缩短平均住院日。     

复合掺杂半导体光催化材料消毒技术的建立及效果评价

目的 设计和研制一种具有自动消毒功能的复合掺杂半导体光催化材料。方法 通过量子化学理论计算半导体氧化物的结构和性能,设计和筛选在可见光条件下具有光催化氧化活性的复合半导体氧化合物,将其掺入硅酸盐材料,通过特殊工艺研制出复合掺杂半导体光催化材料,并对该材料进行消毒效果评价。结果 研制复合掺杂半导体光催化材料,具有自动杀灭细菌和病毒的作用。结论 复合掺杂半导体光催化材料,通过催化氧化分解H₂O产生强氧化性自由基杀灭细菌和病毒,消毒效果达到国家标准,是一种具有见光自动消毒的新型生态环境材料。